Laparoscopy is an increasingly-popular surgical procedure that uses one to five small incisions, each of which is approximately 5-12 millimeters in diameter and extend down, to gain access to an interior surgical site. Each small incision receives a hollow tube or cannula which act as liners to hold the incisions open, thereby providing portals leading down to the interior surgical site. A laparoscopic procedure can then be performed by passing surgical instruments, such as cutting devices, clamps or a viewing apparatus, down the cannulas so that the distal working ends of the instruments can be positioned and used about the surgical site. The proximal handle ends of the instruments remain outside the body where they can be grasped by a surgeon. In some situations, the excised tissue is relatively small and can be passed through the cannula opening, however, in other situations the excised tissue is too large to fit through a cannula intact. In the latter case, the excised tissue must be cut down into a number of smaller pieces before it can be passed through a cannula.
Laparoscopic morcellation is a common method of accomplishing the above described task in the operating room. Further, morcellation also allows many surgeries to be performed laparoscopically, reducing recuperation time and providing cosmetic benefits to patients. Laparoscopic morcellation can be used in surgeries such as hysterectomy, fibroidectomy and myomectomy to remove uteri and uterine fibroids (leiomyomas) through a small abdominal incision. The current standard for the removal of large tissue through a small incision during these surgeries involves grasping tissue and inserting the tissue into a moving cutting tool operating within the body cavity. Some conventional morcellators use blades that are housed in a tube through which the surgeon inserts a tenaculum, grabs part of the tissue, and pulls it through the spinning blades, coring it and aspirating the thin, long piece produced. Other conventional morcellators use bipolar energy to cut the tissue into small pieces that are then removed through laparoscopic ports in a piece-wise manner. A bipolar morcellator applies electricity directly to the tissue through electrodes. The current applied to the tissue causes vaporization and separation of the tissue. Because bipolar morcellators are often inefficient at dissecting large amounts of tissue, they are often used in combination with bladed morcellators.
Unfortunately, the above existing approaches have a number of key limitations; 1) they are time consuming because the devices must be manually moved over the tissue during the cutting step, 2) they do not provide safe containment of tissue during the morcellation process which could lead to seeding (spreading and re-growth) of benign or cancerous tissue, 3) they can lead to accidental damage to surrounding healthy tissue inside the body and 4) the proximity of the morcellator blade to critical structures in the abdomen can result in major morcellation injury to the surrounding tissue, such as a loop of bowel or colon. In addition to these safety risks, current morcellators are inefficient because they operate in a piece-wise or serial manner and the procedure time is highly dependent on tumor size, density, and surgeon skill, thereby prolonging operating time.
Therefore, a laparoscopic morcellator is needed that overcomes the above limitations.